Papal Concession on Condoms—Too Little Too Late

Rev. John Kinkel’s Papal Paralysis: How the Vatican Dealt with the AIDS Crisis

Rev. John Kinkel’s recentbook, Papal Paralysis: How the Vatican Dealt with the AIDS Crisis, offers an important historical review of how papal doctrine led to the Catholic hierarchy’s tragic failure in protecting human life during the HIV & AIDS epidemic, as well as in supporting efforts to create an AIDS-free generation. Kinkel’s review demonstrates how the Vatican’s policies led to widespread adherence to several doctrines that are harmful to public health, including the absolute prohibition of modern contraception and the banning of condoms to prevent HIV transmission. For nearly 30 years, from 1981-2010, there were millions of preventable HIV infections and deaths from AIDS as Pope John Paul II and Pope Benedict XVI occupied the papal throne. The author tells the story of widespread Catholic opposition that failed to overturn these harmful policies for far too long.

From the beginning, there has been a vast schism between HIV & AIDS approaches flowing from the top of the hierarchy versus the on-the-ground realities of how Catholics believe and live. I’ll never forget my visits to Catholic archdioceses throughout Zambia in the late 1990s, at a time when the death rates from HIV & AIDS were rapidly intensifying. I remember being confused, perplexed, disturbed and angry that Catholic institutions would offer hospice services to support a person dying from AIDS and the best care for orphans and vulnerable children, while at the same time they would purposefully limit the use of condoms and even communicate misinformation about their effectiveness, thus inhibiting the prevention of countless HIV infections. But in Zambia I was heartened when I was taken into a back room by the local priest, where he showed me a storage room filled with boxes of condoms. I was assured that those in the diocese were distributing condoms widely because they understood the moral and ethical imperative to protect their parishioners from preventable death and disease. Then, as now, persistently flawed papal doctrines made ministering to those in harm’s way harder and slower. Harmful programs led by the Catholic hierarchy also have created an enabling environment that allows other conservative religious leaders to ally with policymakers in promoting government policies limiting condom access.

Papal Paralysis offers a brief summary of the extremely opaque processes that ultimately result in Vatican policy. Kinkel also documents the failure of 30 years’ worth of public health advocates—both within and outside the church—to overturn these policies. Non-expert readers will learn the choices available to a pope—the different approaches that a pontiff can use to either dig in his heels or work towards reform through papal letters, encyclicals, councils and essays. Strangely, Kinkel moves back and forth from a systemic critique of Vatican policy-making to sporadically singling out certain individuals and their supposed psychological and medical diagnoses as explanations for failed policies. For example, he theorizes that the hyper-conservative battle-ax Cardinal Alfredo Ottaviani was so effective in maintaining the status quo through adherence to semper idem or “no change” because the late member of the curia had a narcissistic personality disorder. In addition, the author hints that the intellectual rigidity of Pope John Paul II may have been attributable to his suffering from Parkinson’s disease. These sporadic layman’s diagnoses of a few key players unfortunately undermine the book’s rightful critique of the hierarchy’s broad failure to adhere to its proclaimed value of protecting human life in the context of the HIV & AIDS epidemic. Similarly, the shadows of the clergy sexual abuse scandal and the Vatican’s entrenched opposition to modern contraceptives are cast by flawed systems, rather than a few ill individuals.

In Zambia I was heartenedwhen I was taken into a back room by the local priest, where he showed me a storage room filled with boxes of condoms.

Miraculously, in 2010 Pope Benedict reversed his long-held stance against condoms and allowed for their use in certain circumstances. Benedict’s reversal of policy might be seen as a religious miracle, but it was definitely an advocacy miracle. Kinkel depicts this guarded approval of condoms as the result of forces for change within and around the church who finally won the battle for a more reasonable policy that balanced religious doctrine and public health. But a hyper-conservative minority, led by zealots within the -Vatican, can effectively prevent reform for decades, despite the fact that millions of Catholic followers, as well as non–Catholics, are suffering and dying all around the world. While ultimately the social movement fighting against HIV & AIDS was heard by the pope, I am left wondering why it took so long and how it is too little, too late for those lost and needlessly suffering.

It took nearly 30 years and nearly 30 million preventable deaths from AIDS to reconcile a harmful prohibition against an evidence-based prevention tool with public health policy—a delay that should seem completely unacceptable to all of us. The main question that I am left with is, “How can Catholics (and other people of faith) join forces with public health experts to influence religious policymaking so that it will work for, rather than against, health policies that protect human health and save lives?” The urgency with which advocates address this faith-based question could affect our collective efforts to achieve an AIDS-free generation, as well as other demographic issues in the years ahead.

Many sectors of the Catholic community never demonstrated a blind obedience to the hard line on HIV & AIDS issues set by the popes and bishops, which offers a hope for the ultimate reconciliation of true Catholic and religious values with public health that could help achieve an AIDS-free generation. Kinkel’s book describes how Catholic leaders in various parts of the world began, as early as 1987, to challenge the harmful doctrines maintained by several popes, including bishops in Europe, Latin America, Africa and the US. Unfortunately, these sporadic and seemingly uncoordinated attempts by well-placed individuals proved to have insufficient impetus to start a progressive movement within the hierarchy as a whole. I was disappointed that the book failed to explain the link between the Vatican’s paralysis in developing a realistic HIV & AIDS policy and the conservative religious and political leaders who promoted abstinence and faithfulness as a panacea to prevent HIV transmission. This is still true—both in the US and in heavily affected countries of sub-Saharan Africa.

As a public health physician, I was trained under the edict of primun non nocere, which is derived from the Hippocratic oath and instructs “above all do no harm.” Kinkel’s book left me wondering if religious leaders, such as the pope, should be held to account by society and their followers for adherence to their own doctrine that believes in the protection of human life—and that, above all, should have religion do more good than harm. It’s clear from the history of the fight against HIV & AIDS that Vatican leadership really does matter, and that this power can be used for positive or negative ends. After the shift under Emeritus Pope Benedict, Pope Francis has an historic opportunity to lend his leadership towards an era of reform and modernization on sexuality, of which the ongoing epidemic is an important facet. Kinkel’s book reaffirms that we urgently need papal action to help create an AIDS–free generation, meet the global need for family planning and end extreme poverty in our time.

Paul S. Zeitz is a longtime advocate for global justice and the realization of human rights. His work on HIV & AIDS started when serving in Zambia from 1994-2000 as advisor for USAID and the government of the Republic of Zambia. On returning to the US, he co-founded and led an advocacy organization called the Global AIDS Alliance from 2000-2011. Since 2011, he hs worked on global HIV/AIDS advocacy through collaboration with several multilateral, donor and civil society organizations.